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      Minimal invasive microscopic tooth preparation in esthetic restoration: a specialist consensus

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          Abstract

          By removing a part of the structure, the tooth preparation provides restorative space, bonding surface, and finish line for various restorations on abutment. Preparation technique plays critical role in achieving the optimal result of tooth preparation. With successful application of microscope in endodontics for >30 years, there is a full expectation of microscopic dentistry. However, as relatively little progress has been made in the application of microscopic dentistry in prosthodontics, the following assumptions have been proposed: Is it suitable to choose the tooth preparation technique under the naked eye in the microscopic vision? Is there a more accurate preparation technology intended for the microscope? To obtain long-term stable therapeutic effects, is it much easier to achieve maximum tooth preservation and retinal protection and maintain periodontal tissue and oral function health under microscopic vision? Whether the microscopic prosthodontics is a gimmick or a breakthrough in obtaining an ideal tooth preparation should be resolved in microscopic tooth preparation. This article attempts to illustrate the concept, core elements, and indications of microscopic minimally invasive tooth preparation, physiological basis of dental pulp, periodontium and functions involved in tool preparation, position ergonomics and visual basis for dentists, comparison of tooth preparation by naked eyes and a microscope, and comparison of different designs of microscopic minimally invasive tooth preparation techniques. Furthermore, a clinical protocol for microscopic minimally invasive tooth preparation based on target restorative space guide plate has been put forward and new insights on the quantity and shape of microscopic minimally invasive tooth preparation has been provided.

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          Biological materials: Structure and mechanical properties

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            Effect of magnification on locating the MB2 canal in maxillary molars.

            The purpose of this study was to determine if the surgical operating microscope and/or dental loupes could enhance the practitioner's ability to locate the second mesiobuccal canal (MB2) canal of maxillary molars in an in vivo, clinical setting. The participating endodontists documented 312 cases of root canal therapy on maxillary first and second molars. Participants that used the microscope or dental loupes located the MB2 canal with a frequency of 57.4% and 55.3%, respectively. Those using no magnification located the MB2 canal with a frequency of 18.2%. When no magnification was used, significantly fewer MB2 canals were located based by Chi-square analysis at p < 0.01. There was no significant difference between the use of the microscope and dental loupes in the frequency of locating the MB2 canal. When the maxillary first molars were considered separately, the frequency of MB2 canal detection for the microscope, dental loupes, and no magnification groups was 71.1%, 62.5%, and 17.2%, respectively. The results of this study show that the use of magnification in combined groups leads to a MB2 detection rate approximately three times that of the nonmagnification group and that the use of no magnification results in the location of significantly fewer MB2 canals. Based on these results, more emphasis should be placed on the importance of using magnification for locating the MB2 canal.
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              An update on local anesthetics in dentistry.

               Andreas Haas (2002)
              Local anesthetics are the most commonly used drugs in dentistry. This article provides a brief update on the pharmacology, adverse effects and clinical applications of these drugs, as well as the role of vasoconstrictors.
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                Author and article information

                Contributors
                yhyang6812@foxmail.com
                zhouxd@scu.edu.cn
                Journal
                Int J Oral Sci
                Int J Oral Sci
                International Journal of Oral Science
                Nature Publishing Group UK (London )
                1674-2818
                2049-3169
                2 October 2019
                2 October 2019
                September 2019
                : 11
                : 3
                Affiliations
                [1 ]ISNI 0000 0001 0807 1581, GRID grid.13291.38, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, , Sichuan University, ; Chengdu, China
                [2 ]Chinese PLA General Hospital, Chinese PLA Medical Academy, Yantai, China
                [3 ]ISNI 0000000123704535, GRID grid.24516.34, Department of Stomatology Digitization, Hospital of Stomatology, , Tongji University, ; Shanghai, China
                [4 ]ISNI 0000 0001 2256 9319, GRID grid.11135.37, Department of Prosthodontics, Hospital of Stomatology, , Peking University, ; Shanghai, China
                [5 ]ISNI 0000 0001 2360 039X, GRID grid.12981.33, Department of Prosthodontics, Guanghua Stomatological Hospital, , Sun Yat-sen University, ; Guangzhou, China
                [6 ]ISNI 0000000086837370, GRID grid.214458.e, Department of Biologic and Materials Sciences and Division of Prosthodontics, , University of Michigan School of Dentistry, ; Ann Arbor, MI USA
                [7 ]ISNI 0000 0004 1761 4404, GRID grid.233520.5, Department of Prosthodontics, School of Stomatology, , The Fourth Military Medical University, ; Xi’an, China
                [8 ]ISNI 0000 0001 0679 2801, GRID grid.9018.0, Department of Prosthodontics, Hospital of Stomatology, , Martin-Luther-University, ; Halle (Saale), Germany
                [9 ]ISNI 0000 0001 2331 6153, GRID grid.49470.3e, Department of Prosthodontics, Hospital of Stomatology, , Wuhan University, ; Wuhan, China
                Article
                57
                10.1038/s41368-019-0057-y
                6802612
                31575850
                © The Author(s) 2019

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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                © The Author(s) 2019

                Dentistry

                fixed prosthodontics, dental caries

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